Phenytoin sodium

(FEH-nih-toh-in SOH-dee-um) A drug used to treat or prevent seizures or convulsions that may be caused by epilepsy, brain surgery, or treatment for brain cancer. It is a type of anticonvulsant agent. Also called Dilantin.

Uses

Due to its effectiveness and relatively low cost, it is considered a first-line treatment for seizures.

Mechanism of action

Phenytoin sodium reduces the activity of specific nerve cells in the brain that are involved in seizure formation. It achieves this by attaching to sodium channels, the proteins responsible for nerve cell electrical activity. By binding to these channels, phenytoin sodium reduces the chance of seizures by slowing the activity of nerve cells.

Administration

There are multiple forms of phenytoin sodium, including pills, capsules, and an injectable solution. Typically, it is administered twice daily, with or without food. The dosage and duration of treatment will depend on the patient's condition and pharmaceutical response.

Indications

Sodium phenytoin has been used for many years to reduce the frequency and severity of seizures and has been found to be beneficial. It is very effective at treating tonic-clonic seizures, often known as grand mal seizures, and partial seizures.

Side effects

However, there are potential negative effects associated with phenytoin sodium use. The most frequent adverse effects include sleepiness, dizziness, and ataxia (uncoordinated movement). Rash, hives, and difficulty breathing are more severe side effects that should be reported immediately to a healthcare provider.

Drug interactions

Phenytoin sodium may interact with other medications; therefore, it is essential to advise a healthcare professional of any medications presently being taken.

Vitamin D metabolism

Phenytoin sodium may potentially influence vitamin D metabolism, resulting in vitamin D deficiency and increased osteoporosis risk (bone loss). It is advised that patients on long-term phenytoin medication have their vitamin D levels regularly monitored and consider vitamin D supplementation.

Pregnancy and breast feeding

Women who are pregnant or breastfeeding should use phenytoin sodium with caution since it might cause birth abnormalities and damage to the nursing child.

Summary

Phenytoin sodium is an excellent treatment for epilepsy and neuropathy-related pain. There are potential adverse effects and interactions associated with its use. Individuals taking phenytoin sodium must inform their healthcare provider of all medications they are currently taking and report any adverse effects. Monitoring vitamin D levels on a regular basis is also recommended for long-term use.

References

1. The American Academy of Neurology. (2010). Phenytoin. In: Neurology. 6th ed. Philadelphia: Saunders.
2. Mattson, R. H., & Cramer, J. A. (2019). Antiepileptic drugs. In: Pharmacology and Therapeutics for Dentistry. 7th ed. Philadelphia: Saunders.
3. National Institutes of Health. (2020). Phenytoin sodium. In: MedlinePlus.

List of antiarrhythmic agents:

• Amiodarone
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• Dofetilide
• Dronedarone
• Flecainide
• Ivabradine
• Mexiletine
• Procainamide
• Propafenone
• Quinidine

• Dailymed label info on Phenytoin sodium
• FDA Phenytoin sodium

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